Outcomes of Positive Interactions between Injection Drug Users' and Their Nurse in an Acute Care Setting

Purpose: To describe the injection drug users’ (IDU) perceptions of received nursing care in the acute care hospital setting.  Substance misuse and abuse is a global issue. It has been well documented that stigma and discrimination of the IDU exists among health caregivers (Myers, Fakier, & Louw, 2009; Neville & Roan, 2014), but there is a dearth of research on the care received from nurses by IDUs. Understanding the experiences of the IDU receiving care from a nurse is imperative in order for nurses and researchers to gain insight into new ways to improve care for this vulnerable and growing population.

Methods: A case study methodology (Yin, 2014) was used and included audiotaped semi-structured interviews with nine IDUs at two needle exchange services (NES). Travelbee’s (1971) Human-to-Human Relationship model served as the framework. Analytic approaches were based on the works of Miles and Huberman (1994). 

Results: Of the nine participants, two identified as Black/African American, three identified as Hispanic/Puerto Rican, and four identified as White/Caucasian. Five of the participants were males and four were female. Three of the participants described positive interactions with their nurse that resulted in the development of rapport according to Travelbee’s (1971) framework. These interactions resulted in a change in behavior outcome that reduced the harm related to injection drug use.

Conclusion: Results indicate that acute care nurses require additional education and role support regarding addiction and caring for the IDU. The nurse played a pivotal role in how the IDU acted and reacted when hospitalized. When the nurse connected to the IDU on an interpersonal level, the outcomes included: harm reduction techniques; reflection on drug use resulting in decreased use; a verbalized decrease in time seeking care for future health related needs; and willingness to be transferred to a detoxification unit. The nurse played a pivotal role in the overall hospitalization experienced by the IDU. Implementation of harm reduction education by the nurse was shown to be an effective tool that resulted in behavioral changes for the IDU.